摘要
背景:椎体强化是治疗骨质疏松性椎体压缩骨折应用普及的有效方法,但有研究认为椎体强化会导致强化椎体相邻节段发生再骨折。目的:分析骨质疏松性骨折行椎体强化后,再发相邻椎体骨折和非相邻椎体骨折的临床特点和预测因素。方法:回顾性分析187例接受骨水泥椎体强化治疗单节段椎体压缩骨折患者的临床资料,记录患者的病历信息和手术相关数据,使用卡方检验、独立样本t检验、Mann Whitney U检验进行单因素分析,将P<0.2的变量纳入多因素logistic回归分析。结果与结论:(1)187例患者中,共41例患者发生其他节段的再次骨折,再骨折发生率21.9%;41例再骨折患者中,相邻椎体再骨折23例,占56.1%;非相邻椎体再骨折18例,占43.9%;(2)初次骨折为胸腰段骨折是强化椎体相邻节段再骨折发生的独立预测因素(P=0.017);年龄、性别、身高、体质量、有无糖尿病、有无抗骨质疏松治疗、有无既往骨折病史、有无骨水泥渗入椎间隙、骨水泥弥散好坏、注入骨水泥量、术式为椎体成形或椎体后凸成形、术后椎体前缘高度恢复的比例、术后区域后凸角改变、骨密度T值、再骨折位于强化椎体上方或下方,这些因素均不能预测再骨折发生在强化椎体的相邻节段或非相邻节段。
BACKGROUND： Percutaneous kyphoplasty （PKP） and percutaneous vertebroplasty （PVP） are effective treatments for osteoporotic vertebral compression fractures （OVCF）, but studies have suggested that augmented vertebrae may lead to refracture located in adjacent vertebrae. OBJECTIVE： To identify the characteristics and predictive factors of the adjacent and non-adjacent refractures after PKP and PVP. METHODS： A retrospective analysis of 187 single-segment OVCF patients undergoing PKP or PVP wasconducted. Clinical, imaging and surgical data were recorded and analyzed by chi-square, t test and Mann Whitney U test. The variants with P value 〈 0.2 were used for multiple logistic regression analysis. RESULTS AND CONCLUSION： （1） Among 187 cases, 41 patients suffered refractures, and the total refracture rate was 21.9%. Twenty-three patients （56.1%） had refractures in the adjacent vertebrae, and 18 patients （43.9%） had refractures in the non-adjacent vertebrae. （2） The first fracture in thoracolumbar segment was the independent predictive factor for adjacent refratures in augmented vertebrae （P=0.017）. Others （age, sex, height, body mass, presence or absence of diabetes mellitus, anti-osteoporosis treatment, history of fractures, cement leakage into interbody, cement diffusion, the bone cement volume injected, performed PKP or PVP, the percentage of anterior vertebral height restoration, the correction of the Cobb angle, bone mineral density, above or below of the refractured vertebrae compared to the augmented one） are not associated with the adjacent or non-adjacent refractures.
作者
黄天霁
张施洋
鲁超
Huang Tian-ji;Zhang Shi-yang;Lu Chao(Department of Orthopedics,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)
出处
《中国组织工程研究》
CAS
北大核心
2018年第27期4342-4347,共6页
Chinese Journal of Tissue Engineering Research
作者简介
黄天霁,男,1989年生,四川省泸州市人,汉族,2016年北京大学毕业,博士,医师,主要从事骨科的临床和基础研究.;通讯作者：鲁超,博士,主治医师,重庆医科大学附属第一医院骨科,重庆市400016
